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[55] If nervous system damage is present and blood testing is inconclusive, a lumbar puncture may be carried out to measure cerebrospinal fluid B 12 levels

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33,34,35,36,37 One study suggests that length of time from diagnosis of cognitive impairment is important for response rate, in that patients who had experienced symptoms for less than 12 months improved on B12, whilst those with symptoms for more than 12 months continued to decline

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If you are using oral capsules, none of the above applies you only need the capsules themselves

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